Would you choose location over specialty?

[ari202]

Just curious, I am quite positive I will be sticking with Psych but the amount of Psychiatry I do in my Family Medicine clerkship is astonishing. I also like the allure of keeping up with guidelines and treating medical issues as well.

However, the family friendliness of Psychiatry residency makes it a more practical choice for me as a future mom. The biggest issue is that my hubby has a good job and good support here in California. I'm a DO student with borderline board scores (high 400's on my comlex) and I would like to make life simple for my family as well as enjoy what I do.

I have more options for Family medicine (locally) than I would for Psychiatry locally. My husband would be a lot happier and we would have a lot of support if I stayed locally.

The predicament is, I am not sure if I will be able to do everything a family medicine physician does (suturing, small procedures) as I just don't like it all that much. I really enjoy the Psych aspect of Family though. In essence, I would probably like Psych more than Family but I also don't want to put my family through a lot of changes.

I'm curious if anyone has faced this issue before and if they could share what they decided? Location vs specialty?

Thanks

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[AMEHigh]

I chose specialty 100%.

You can move after you finish residency, but once you choose a specialty, that's it (I know technically you can switch, but you know what I mean.) I'd rather be somewhat unhappy in a not ideal location for 3-5 years while doing my residency than be unhappy in a specialty for the rest of my career.

 

[Beacopp665]

When you say more options for family locally than psych how many programs are there of each in your area? They tend to be roughly the same competitiveness so if you really love psych and there are enough programs around just go for them and let them know your ties to the area and you should be fine

 

[gutonc]

Answer this question instead of the one you asked.

"Would I rather spend 4 years doing something I loved in a place I hated or a lifetime doing something I hated in a place I loved?"

Because that's the real issue here. Residency is time limited. Your specialty is forever.

Also, you say you want to stay in California. But I probably don't have to remind you that California is a really big place and that there may be several other programs out of state (but closer to where you currently live) than some of the other California programs.

 

[ari202]

Answer this question instead of the one you asked.

"Would I rather spend 4 years doing something I loved in a place I hated or a lifetime doing something I hated in a place I loved?"

Because that's the real issue here. Residency is time limited. Your specialty is forever.

Also, you say you want to stay in California. But I probably don't have to remind you that California is a really big place and that there may be several other programs out of state (but closer to where you currently live) than some of the other California programs.

Yes that's true, and unfortunately I haven't had a lot of luck their either.

I don't necessarily hate Family Med, its just that I like psych a little more. But I do see your point.

 

[organdonor]

I don't know how far into the application process you are, but you could apply to both. You could interview at both and see which programs seem like a better fit. I'm in family med and it would be hard to imagine more family friendly residencies than some of the ones to which I applied. Family docs do a heck of a lot and can mold their practice pretty much as they see fit but I have to say I haven't heard of many FM guys doing more psych than your typical outpatient depression and maybe steady bipolar or schizo.

If you are not a fan of the broad scope of practice them those surgery months and 3 am continuity deliveries could get pretty miserable.

 

[evilbooyaa]

Personally, Hell to the no.

However, I do understand that people's priorities can be different than mine.

 

[ari202]

thanks for the feedback guys. i enjoy fp/im aspects of primary care. but psychiatry is just too damn fun to pass up!

 

[rokshana]

thanks for the feedback guys. i enjoy fp/im aspects of primary care. but psychiatry is just too damn fun to pass up!

you should do psych...sure there is a LOT of psych in IM and i would presume FM, but if you can say "psych is just too damn fun"...you are supposed to do psych...

do some aways at the programs that you would want to go to and let them know that you are a local, and want to stay...and shine while you are there...psych is not so competitive and in the end programs want someone that they feel fits in and will do the work...

 

[Siggy]

As others have said, sure... provided there's an extremely compelling reason to limit your location (you aren't 18 anymore, so it has to be better than not moving away from your parents) AND the second choice specialty is high on your interest list anyways. I wouldn't do something I hate just to keep me in X location.

 

[jakeislove]

I'd choose Psychiatry.

FP is boring.

 

[dozitgetchahi]

I'd choose Psychiatry.

FP is boring.

When the OP said 'the allure of keeping up with guidelines' in the first post I nearly fell out of the chair laughing. Do psych.

 

[jakeislove]

When the OP said 'the allure of keeping up with guidelines' in the first post I nearly fell out of the chair laughing. Do psych.

Nothing beats psych.

 

[Leo Aquarius]

Nothing beats psych.

Psych is great. Nothing like it. It's fascinating, it's terribly needed, and it's fun.

 

[Frazier]

Sounds like you like psych most.

Easy choice: Psych all day!

 

[Leo Aquarius]

Psychiatry hits the sweet spot for me. Sure I find other things in medicine compelling - treating cancer fascinating, working up chest pain interesting, analyzing CT scans intriguing, and would enjoy being a radiologist/oncologist/cardiologist for a day. But picking a specialty this way is like choosing a gigantic iceberg by only looking at the tip. Every specialty has a daily grind, and you have to be really into the grind you pick. For me, I truly enjoy helping people get back to living their lives by working past things like depression, schizophrenia, mania, addictions, etc. Then there's the whole legal/forensic aspect - determining capacity, legal holds, etc. Using not only medications, but therapy and other modalities. There's also the whole work-life balance, the rise of telepsychiatry, and relatively low stress on the job. Also, most other doctors are afraid to touch psych patients. Where I work the surgeons and medicine teams come crying whenever they have a psych patient, so we save the day. It's definitely not for everyone, but it's very satisfying. In this specialty you discover a patient or family member thanking you for the work you do almost every day.